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A Guide to VA Nursing Homes: Does the VA Pay for Nursing Home Care?

Kara Lewis
By Kara LewisJune 17, 2021
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If you or your senior loved one is a veteran, this past service can often make senior living more affordable. The U.S. Department of Veterans Affairs (VA) has a variety of programs and benefits that help provide long-term care to veterans. VA nursing homes, also called VA community living centers, stand out as a popular and accessible senior living option for older veterans.

Currently, more than 100 VA community living centers serve veterans all across the country. These VA nursing homes typically house veterans on or near the campus of a VA medical center. Learn more about the services they offer, associated costs for veterans and their families, and how to determine if a nursing home is the right fit for your loved one’s care needs. 

What services do VA nursing homes provide?

Specific services VA nursing homes offer can vary by state. In general, however, veterans and their caregivers can expect the following care, administered by licensed professionals:

  • Round-the-clock care and supervision; a medical professional is always on-staff and available
  • Help with activities of daily living (ADLs), like bathing, getting dressed, and eating
  • Wound dressing and treatment
  • Medication management
  • Assistance with insulin and IVs
  • Preventative and restorative care, such as routine doctor appointments and physical therapy

Care plans at many community living centers include a wider range of assistance:

  • Mental health counseling, including PTSD treatment
  • Adult daycare programs, which non-residents also can attend
  • Hospice or end-of-life care

In addition to addressing physical and mental health, VA nursing homes also help prevent social isolation in seniors. Like in most other senior living settings, residents in VA community living centers can expect a wide range of group activities — like games, movie nights, performances by visiting choirs, and social hours — as well as nutritious, communal meals. A VA nursing home can also minimize both senior and caregiver stress by providing consistent housekeeping, laundry, and maintenance.

Find and contact a VA community living center in your area to ensure staff can meet your or your loved one’s specific health needs.

How to qualify for VA nursing home care

To be eligible for VA nursing home care, a person must be enrolled in VA health care benefits. The first steps are to make sure your family member meets the requirements and to submit an application.

Determine eligibility for VA health care

To access VA health care benefits, veterans need to have served in active duty and to have received an honorable discharge. While these standards represent minimum requirements, your senior loved one can enhance their eligibility and gain a higher priority level — meaning they are more likely to receive care — if at least one of the following is also true:

  • They receive VA payments for a disability connected to their service
  • They were discharged from the military due to a service-connected disability, injury, or health condition
  • They earn a VA pension
  • They are a former prisoner of war (POW)
  • They were awarded with a Purple Heart or Medal of Honor
  • They receive or qualify for Medicaid benefits

If a veteran served in specific locations during the following wartime periods, this also increases their eligibility.

  • Camp Lejeune: Aug. 1, 1953 – Dec. 31, 1987
  • Southwest Asia: Aug. 2, 1990 – Nov. 11, 1998
  • Vietnam: Jan. 9, 1962 – May 7, 1975

Even if these eligibility factors aren’t true for a veteran, it’s still possible to qualify for VA health care based on annual income. If you or your loved one earned less than the 2021 income maximums listed below last year, they may qualify based on need. These figures have been set as “income thresholds,” meaning that if a veteran or their spouse brings in more money in a given year, they won’t qualify based on financial need.

No dependents

One dependent

Two dependents

Three dependents

Four dependents

For each additional dependent

$38,078

$45,693

$48,313

$50,933

$53,554

Add $2,382

Additional qualifications for VA nursing homes

After determining eligibility for VA health care, the VA must find all three of the following true in order to admit a patient to a community living center:

  • The patient is signed up for VA health care
  • The patient requires VA nursing home services
  • A nearby community living center has adequate space for the veteran

For the VA to determine that a patient requires VA nursing home services, healthcare professionals must identify a “medical need.” The definition of medical need can vary by state.

How much does the VA pay for nursing home care?

Does the VA pay for nursing home care? In short, yes, though veterans may or may not have a copay based on their priority group. A veteran’s priority group takes into account details like their level of disability, their income, and their service history.

While no veteran will pay for their first 21 days in a community living center or for hospice care, some veterans may pay up to $97 a day for continued long-term care. Contributions from Medicaid or a senior’s private insurance may reduce these health care costs.

A veteran’s copay is likely to change if their priority level or their income shifts significantly.

Is a VA nursing home the right fit for my loved one?

Though “nursing home” is often used as a general term for senior living, there are actually many care types available. After exploring various  senior care options, older adults and caregivers  may decide their needs would be better met by a different care model, like assisted livingmemory care, or independent living.

In fact, A Place for Mom surveyed 100 families who contacted us seeking “nursing homes” for their relatives. After consulting with our Senior Living Advisors, 89 of those families identified that a nursing home wasn’t the right choice for their aging family member. Before submitting an application for VA nursing home care, consider if the level of care offered by a nursing home best fits your loved one’s unique needs. 

Generally, nursing home residents have serious and chronic mental or physical illnesses which demand a higher level of care. Try asking yourself the following questions to gauge if your family member would benefit from a nursing home:

  • Are they recovering from an injury, stroke, or surgery?
  • Do they need access to 24-hour skilled medical care?
  • Do they have a complex, progressive, or cognitive health condition?
  • Do they fall frequently?
  • Are they bedbound, or unable to get into and out of a wheelchair independently?
  • Can they no longer feed themselves or maintain their dental health?

If your answer to any of these questions is yes, the intensive level of care provided by a nursing home may be the right fit. A physician can confirm this designation and prescribe nursing home care.

Does the VA pay for other types of senior living?

If your family member doesn’t require nursing home care, but does need help with everyday activities or memory loss, the VA may pay for assisted living, memory care, or home care services through a program called Aid and Attendance. Single veterans may receive up to $1,936 per month to help them pay for care, while married veterans can see up to $2,295 in monthly payments.

Start the VA health care application process

If you or your family member already gets VA health care benefits, complete the VA form for extended care services. You’ll need to list information like current income, deductible expenses, and the value of any assets.

If you don’t already receive VA health care benefits, this marks a necessary first step to securing your spot in a VA nursing home. Apply online or download and mail in the printed enrollment form. You’ll need important pieces of information and documents on-hand when you apply:

  • Social security numbers for the veteran, their spouse, and any dependents
  • Military discharge papers
  • Insurance coverage information, including insurance cards from Medicare or a private company
  • The previous calendar year’s gross household income for the veteran, their spouse, and any dependents
  • The previous calendar year’s deductible expenses

Contacts and resources for veterans

The process of applying for a VA nursing home can be complicated, but a trustworthy expert can help you navigate it. Consider finding an elder care attorney in your area, visiting your local VA facility, or calling the VA at 800-698-2411.

Sources:

U.S. Department of Veterans Affairs. Community Living Centers. https://www.va.gov/GERIATRICS/pages/VA_Community_Living_Centers.asp 

U.S. Department of Veterans Affairs. Eligibility for VA Health Care. https://www.va.gov/health-care/eligibility/

U.S. Department of Veterans Affairs. Annual Income Limits. https://www.va.gov/healthbenefits/apps/explorer/AnnualIncomeLimits/HealthBenefits

Kara Lewis
Author
Kara Lewis

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